Expression of
cyclooxygenase-2 (COX-2) has been reported to be elevated in human colorectal
adenocarcinoma and other
tumors, including those of breast, cervical, prostate, and lung. Genetic knock-out or pharmacological inhibition of COX-2 has been shown to protect against experimentally-induced
carcinogenesis. Results from epidemiological and laboratory studies indicate that regular intake of selective
COX-2 inhibitors reduces the risk of several forms of human
malignancies. Thus, it is conceivable that targeted inhibition of abnormally or improperly elevated COX-2 provides one of the most effective and promising strategies for
cancer chemoprevention. The COX-2 promoter contains a TATA box and binding sites for several
transcription factors including
nuclear factor-kappaB (
NF-kappaB), nuclear factor for
interleukin-6/
CCAAT enhancer-binding protein (NF-
IL6/C/EBP) and
cyclic AMP response element (CRE)
binding protein. Upregulation of COX-2 is mediated by a variety of stimuli including
tumor promoters, oncogenes, and
growth factors. Stimulation of either
protein kinase C (PKC) or Ras signaling enhances
mitogen-activated protein kinase (MAPK) activity, which, in turn, activates transcription of cox-2.
Celecoxib, the first US FDA approved selective
COX-2 inhibitor, initially developed for the treatment of adult
rheumatoid arthritis and
osteoarthritis, has been reported to reduce the formation of
polyps in patients with
familial adenomatous polyposis. This COX-2 specific inhibitor also protects against experimentally-induced
carcinogenesis, but the underlying molecular mechanisms are poorly understood. The present review covers the signal transduction pathways responsible for regulating COX-2 expression as novel molecular targets of chemopreventive agents with
celecoxib as a specific example.